Soft tissue biomechanics

Transcription

1 Soft tissue biomechanics Caroline Öhman Pula, 22/06-08

2 TABLE OF CONTENTS Introduction to soft tissues Tendon and ligaments Introduction Composition Function and structure In vitro testing Stress-strain curves mechanisms Failure modes Visco-elasticity 2

3 INTRODUCTION The human body is composed of many different kinds of soft tissue: cartilages; epithelial tissues; menisci; inter-vertebral disks; muscles; nervous tissues; ligaments; adipose tissue; tendons, etc. 3

4 INTRODUCTION Common properties of soft tissues: Negligible mineral content => low stiffness Large content of water (up to 90%) Organic components (collagen, elastin, proteoglycans) always present Mainly extra-cellular matrix Cellule: fibroblasts and fibrocytes (and derived cells) Visco-elastic behaviour is very pronounced BUT, different functions and structures: support (articular cartilage, menisci); filling (elastic cartilage); storage of resources, thermal protection (adipose tissue); protection, absorption, diffusion (epithelial tissues); mechanical connection (ligaments, tendons and muscles). 4

5 INTRODUCTION Common properties of soft tissues: Negligible mineral content => low stiffness Large content of water (up to 90%) Organic components (collagen, elastin, proteoglycans) always present Mainly extra-cellular matrix Cellule: fibroblasts and fibrocytes (and derived cells) Visco-elastic behaviour is very pronounced BUT, different structures and functions : support (articular cartilage, menisci); filling (elastic cartilage); storage of resources, thermal protection (adipose tissue); protection, absorption, diffusion (epithelial tissues); mechanical connection (ligaments, tendons and muscles). 5

6 INTRODUCTION Soft tissues that will not be dealt with in this lesson: MUSCLE TISSUES Mechanical properties as defined so far are passive properties (elastic, plastic, visco-elastic) Mechanical response of muscles predominantly depends on their active function Difficult extract and conserve muscle tissue without degenerating its properties Muscles are not isolated bodies, there may be an interaction with one or several contiguous muscles 6

7 TENDONS AND LIGAMENTS Tendons: connect a skeletal bone to a muscle: transmitting muscle force Ligaments: in joints, linking two bones Ligaments & tendons are similar: Both transmit longitudinal loads Almost only tensile Wrapped in a layer of loose connective tissue (allow sliding with little friction) Muscle Tendon Ligaments Bones Ligaments & tendons are different: Tendons act very often: transmit muscle forces (for motion, locomotion, etc.) Ligaments loaded heavily only occasionally: to avoid joint damage (dislocation, etc.) 7

8 FUNCTION AND ANATOMY OF TENDONS Each muscle has one, both or none extremity connected to a tendon Long and with a quite constant section, different possible cross sections: Rounded cylindrical Flattened Severely loaded muscles (e.g. quadriceps) have short and thick tendons Muscles performing precise motion with light loads (e.g. flexors and extensors of hand have long, slender tendons Biomechanical functions: Avoid excessive muscle length Localize muscles in areas where they do not interfere (e.g. hand) Absorb shocks and minimize impulsive load on muscles 8

9 COMPOSITION OF TENDONS Composite material 1=> Reinforcement: Bundles of collagen fibres (50-80% volume => yellow) Aligned with load (along tendon) Optimised for axial loading Little resistance to transverse loads 2=> Matrix: Proteoglycans (2-10%) Elastin (2-5%) Supports fibres and shares load between fibres Ties fibres together 3=> Cellule: Tenoblasts: (similar to fibroblasts) build the matrix Tenocytes: derive from tenoblasts, inside tissue 4=> Nerves, blood vessels, lymphatic 9

10 FUNCTION AND STRUCTURE OF TENDONS Most of load directly transmitted by collagen fibers Fibers progressively stretched and recruited 10

11 LIGAMENTS AND TENDONS:COMPOSITION Tendons and ligaments have similar composition: Mainly made of collagen Different arrangement of the fibers 11

12 FUNCTION AND STRUCTURE OF LIGAMENTS Similar composition to tendons Different arrangement of collagen fibers: More wavy Arranged in layers Initially compliant, then stiffening 12

13 BONE INSERTIONS OF TENDONS & LIGAMENTS Collagen fibers (of both ligaments & tendons) extend below bone surface: This fibrocartilage extends inside bone: In some cases transition to calcified tissue is sharp In other cases a gradient of mineralization is found along the collagen fibres: Gradient of mechanical properties (stiffness increase with %mineral) Transition minimizes stress concentration due to discontinuity 13

14 MUSCLE INSERTION OF TENDONS Collagen fibres of tendon extend across the insertion into the muscle Mechanical strength: Stress concentration is reduced Interface for transmission of force is one order of magnitude larger than cross section of tendon 14

15 IN VITRO TESTING OF TENDONS & LIGAMENTS Different specimen geometries can be tested: whole complex (bone-tendon-muscle or bone-ligament-bone) single tendon or ligament single fascicles Problems with not whole complex: Difficult to cut a specimen without damaging material texture Excised specimens difficult to clamp without causing stress concentrations (cutting failure) 15

16 TESTS ON BONE-TENDON TENDON-MUSCLE & BONE-LIGAMENT LIGAMENT-BONE COMPLEX Considering ligaments/tendons with surrounding structures: Failures in tendons may occur: Bone-tendon interface Muscle-tendon interface In central part of tendon Possible failure sites in ligaments: Bone-ligament interface (high speed) Core of ligament (low speed) Muscle Tendon Ligaments Bones 16

17 DEFINING AND MEASURING DIMENSIONS Cross section needed to compute stress: Area & geometry of cross section are not constant along ligaments Difficult to assure precise measurements Length needed to compute strain: Pre-tensioning of fibres are lost during dissection Preferable to measure deformation on the central portion 17

18 STRESS-STRAIN STRAIN CURVES OF TENDONS & LIGAMENTS Under physiological stress: Tendons: Transmit muscle loads Minimal dissipation required for cyclic loads (e.g. walking) Ligaments: Must be very compliant in physiological range (must not hinder motion) => no muscle work Must become stiff if joint is close to dislocation 18

19 DIRECTION DEPENDENT Longitudinal-transverse testing Medial collateral ligament Tendons and ligaments have an anisotropic structure: work almost only in tension along axis of ligament/tendon 19

20 MECHANISM BEHIND STRESS-STRAIN STRAIN CURVES Qualitatively similar regions in stress-strain curve in tendons and ligaments: (MPA) 100 Stress 0-A) First part has increasing slope (stiffening): Uncoiling and straightening collagen fibers PATELLAR TENDON A B Tangent Modulus C III II I Strain (%) FAILURE LINEAR TOE Shear motion of the hydrophilic gel surrounding collagen fibres Tendons: up to 1.5-4% stretch Muscle pre-tension sufficient to exceed this part to avoid slack Ligaments: stress <3MPa No relevant muscle work 20

21 MECHANISM BEHIND STRESS-STRAIN STRAIN CURVES Qualitatively similar regions in stress-strain curve in tendons and ligaments: (MPA) 100 Stress A-B) Almost-linear response for increasing stress Complete straightening of collagen fibers PATELLAR TENDON A Tangent Modulus Strain (%) At the end of this region: small drop of stress: first collagen fibers get damaged Tendons: the region tendons are cycling during physiological activity Linear, highly reversible: elastic energy accumulated is released when unloading B C III II I FAILURE LINEAR TOE Ligaments: the normal field of action for constraining motion in normal tasks Ligament response becomes stiffer (=quicker) to avoid dislocation 21

22 MECHANISM BEHIND STRESS-STRAIN STRAIN CURVES Qualitatively similar regions in stress-strain curve in tendons and ligaments: (MPA) 100 Stress B-C) Progressive damage, up to failure PATELLAR TENDON A B Tangent Modulus C III II I Strain (%) FAILURE LINEAR TOE This stress level is reached only in trauma conditions Tendons: stress = MPa (10-15% strain) Ligaments: similar stress; larger strain, up to 70% In physiological conditions applied stress never exceed 1/3-1/4 of failure stress 22

23 DAMAGE & FAILURE 1 Reversible strain (physiological loading): Fibers progressively stretched and recruited Slope is increasing Tends to become linear POSTERIOR CRUCIATE LIGAMENT 2 First fibers fail: First damage when curve still linear Load fluctuates 3 Peak load: most fibers stretched & ready to fail 4 Residual strength after damage: Ligament length is irreversibly increased (joint is loose) 23

24 VISCO-ELASTICITY Both ligaments and tendons show visco-elastic behavior: Much more pronounced in ligaments (dissipative) than tendons (almost-reversible) Visco-elastic tests: Hysteresis Asymptotic relaxation 24

25 VISCO-ELASTICITY Conditioning for cyclic loading: Drifting of stress-strain curves for the first cycles Then stabilizing 25

26 VISCO-ELASTICITY Strain rate affects: Slope of stress-strain curve (apparent stiffness) Failure load Force high-rate low-rate Extension 26

27 TENDONS & LIGAMENTS : CHANGES WITH AGE Rapid change of mechanical properties adolescent/adult Bone insertions are weaker initially (adolescent), then exceed the strength of ligament/tendon bulk part. Failure mode tends to shift: Avulsion of insertion site (adolescent) Failure of mid-portion (adult) 27

28 TENDONS & LIGAMENTS : CHANGES WITH AGE Progressive change of mechanical properties with ageing in adult Size of collagen fibrils increase with age Stiffness and ultimate load decrease with age 28

29 TENDONS & LIGAMENTS : ADAPTATION TO MECHANICAL STRESS Like all tissues: Increased material properties and cross-section in case of increased stress Decreased in case of immobilization Rapid resorption process (weeks-months) Healing and recovery slower - faster for ligament/tendon tissue, slower for bone insertion 29

30 Thank You 30